Department of Infertility and Reproductive Medicine, Zekai Tahir Burak Women's Health and Research Hospital, Ankara, Turkey.
Taiwan J Obstet Gynecol. 2012 Sep;51(3):393-6. doi: 10.1016/j.tjog.2012.07.013.
In this study, the Ki-67 proliferative indices among the stages of the endometriosis were compared to clarify whether the proliferation was increased with increasing disease stage.
Thirty-eight patients who underwent surgery either by laparotomy or by laparoscopy with the diagnosis of endometriosis and 21 patients, as controls, who underwent hysterectomy with the diagnosis of myoma uteri and without any endometrial pathology at our hospital between 2005 and 2007 were studied. Biopsy specimens of endometriotic foci and endometriomas in study group, and eutopic endometrium of hysterectomy specimens of control group were studied.
Fifty-nine patients were divided into Group 1 (21 patients in control), Group 2 (19 patients in stage I and II of endometriosis), and Group 3 (19 patients in stage III and IV). A moderate correlation between the stage of endometriosis and the degree of Ki-67 staining was found. When Ki-67 immunohistochemical staining was considered according to the threshold value for CA-125 (35 U/mL), Ki-67 positivity was increased with the increase in CA-125 value, but this increase was not statistically significant.
Endometriosis shows some characteristics of tumors such as high rate of invasion, getting autonomy, and proliferation as the disease progresses with subsequent damage to target organs. When the stage of the disease increases, environment becomes more suitable for increased proliferation and invasion. In this study, the increase in proliferative activity as the severity increases is shown by the increase in Ki-67 index. As more studies are being conducted in this field, pathogenesis will be clarified, which could help in the development of new treatment modalities.
本研究比较了子宫内膜异位症各期的 Ki-67 增殖指数，以明确增殖是否随疾病分期的增加而增加。
本研究纳入 2005 年至 2007 年间在我院因子宫内膜异位症行剖腹手术或腹腔镜手术的 38 例患者（研究组）和因子宫肌瘤行子宫切除术且子宫内膜无任何病理改变的 21 例患者（对照组）。研究组中子宫内膜异位症病灶和卵巢子宫内膜异位囊肿的活检标本，以及对照组中子宫切除术标本的在位子宫内膜均行研究。
59 例患者分为 3 组：第 1 组（对照组，21 例）、第 2 组（Ⅰ期和Ⅱ期子宫内膜异位症，19 例）和第 3 组（Ⅲ期和Ⅳ期子宫内膜异位症，19 例）。发现子宫内膜异位症分期与 Ki-67 染色程度之间存在中度相关性。当根据 CA-125（35 U/mL）的阈值对 Ki-67 免疫组化染色进行考虑时，Ki-67 阳性率随着 CA-125 值的增加而增加，但这种增加无统计学意义。
随着疾病的进展，子宫内膜异位症表现出一些肿瘤的特征，如侵袭率高、获得自主性和增殖，随后对靶器官造成损害。随着疾病分期的增加，环境变得更有利于增殖和侵袭的增加。在本研究中，Ki-67 指数的增加表明增殖活性随严重程度的增加而增加。随着该领域更多研究的开展，其发病机制将得到阐明，这有助于开发新的治疗方法。
